What you can’t find in the packet of ultra-processed food product or UPF is more likely to be real or whole food. UPFs are packaged food products that are industrially manufactured, chemically or physically transformed, ready-to-eat affordable and very aggressively advertised. These are formulations of oils, fats, sugars, starch, and other products. These often contain flavourings, colourings, emulsifiers, and other cosmetic additives. UPFs contain substances that are not usually found in domestic kitchens. If a food product contains more than five ingredients, it is likely to be UPF. When I told this to my 10-year-old grandson, he became more careful in choosing foods from the shelf.
The UN Food and Agriculture Organization (FAO) recognises that increasing consumption of ultra-processed food products is associated with poor health outcomes and recommends limiting the consumption of UPFs through policies and regulations.
There is emerging a global scientific consensus on this issue as seen from the series of publications that recently appeared in the reputed medical journals like Lancet Gastroenterology & Hepatology, Lancet Endocrinology and the British Medical Journal. Increasing consumption of UPFs is a global problem. However, it is not yet a pressing issue in India even as there is knowledge linking food processing to poor health.
In 2010, Brazilian scientists noted that in spite of decreased per capita sugar consumption, obesity was rising. They came up with a new classification of foods/food products based on the degree of processing and termed it ‘Nova classification’ (meaning new classification). It has four food groups. Group 1 consists of unprocessed or minimally processed foods such as fruits, vegetables, pulses, rice, eggs, meat, fish, or milk. Group 2 consists of processed culinary ingredients, including salt, vegetable oils, butter, sugar, and other substances used to prepare meals. Group 3 is ‘processed foods’, which consist of canned vegetables or fruits with added salt or sugar. Group 4 consists of UPFs like soda, ice cream, bakery items, biscuits, and chocolates.
Not all processing is bad. For millions of years people have used fermentation, heating, sun drying, cooking, minimal processing such as turning wheat to flour and making of chapattis or cooking with spices to enhance taste and flavours. Food has also been preserved before.
Increasing Consumption of UPFs
The market led to mass production and made these affordable. Aggressive marketing created the demand by projecting these as ‘healthy’ and contributed to increased consumption. The US tops the list with 57 per cent of the daily energy intake coming from UPFs. Several countries that follow are the United Kingdom, Canada, Barbados, Australia, France, Belgium, Chile, Brazil, Taiwan and Mexico. Colombia has the least usage of UPFs at 15.9 per cent.
India is not yet on this list, however, data from the past 15 years suggests rising consumption of both food and beverage products. According to a study commissioned by Food Safety and Standards Authority of India (FSSAI), more than 1,300 packaged food and beverage products sold in India are high in salt, sugar or saturated fats and therefore unhealthy.
Prevalence of obesity in India, which is a major health risk, has increased by nearly 25 per cent during the last five years, both in adult men and women. Ultra-processing alters the food matrix and its structure, which destroys the nutrition quality and affects the satiety centre that makes you eat more. High consumption of ultra-processed diets has been found to be associated with chronic diseases like overweight, type-2 diabetes, cancers, hypertension, heart disease. People who consumed 10 per cent increased UPFs in their diet had a 15 per cent greater chance of developing type-2 diabetes.
New research highlights how UPFs can also significantly accelerate a person’s cognitive decline. A cohort study by UK Biobank shows association of UPF intake and Covid. Studies also reveal the link of consumption of ultra-processed food with dementia and many cases of anxiety and depression.
What makes the UPFs harmful?
UPFs work through various mechanisms. Evidence shows that ultra-processing is linked to negative health outcomes independent of the nutrient content. Being mostly high in salt, sugar or fats is harmful and it displaces the unprocessed or minimally processed foods. There are trillions of gut microbes, which protect human health through core functions such as digestion, metabolism and immune mechanisms; and intake of UPFs alters this arrangement thereby losing out on this protection. Food additives such as colorants, emulsifiers can lead to chronic inflammatory diseases. Some beverages include artificial sweeteners, which can cause cancers. During packaging, potentially toxic compounds are added into the food, especially with long exposures.
What can India do?
Article 21 of the Constitution of India guarantees protection of human life and health. There is enough evidence to say increasing consumption of UPFs is harmful to human health. The government of India may recognise Nova Classification to conduct dietary surveys and aim at stalling the rising consumption. Consumers need to know about the risks of diets high in UPFs in local languages to reduce their consumption. Examples of tobacco campaigns may be used.
Regulation of UPFs should aim to end advertisements especially targeted at children and adolescents. The State can make other policies such as a warning label on packs of unhealthy food products and a highest slab of GST may be imposed on them.
India need not wait for the consumption of UPFs to go up before taking action.
Dr Arun Gupta is a senior paediatrician, convener of Nutrition Advocacy in Public Interest (NAPi) and former member of the PM’s Council on India’s Nutrition Challenges. He tweets @Moveribfan. Views are personal.
(Edited by Ratan Priya)